If your child’s baby tooth suffers extensive decay, infection, or trauma, damage to the tooth’s pulp can occur. Pain, visible decay, darkened enamel, sensitivity, redness, pus, or a pimple-like spot on the gums can be symptoms of pulp injury or infection, and should be evaluated by a dentist immediately.

Pulp is living tissue containing nerves and blood vessels. It’s found in the pulp chamber and in the root canals inside each tooth. Infection and inflammation in the tooth pulp can cause premature tooth loss. Infection can spread to the surrounding gums and bone. In some cases, the development of the permanent tooth beneath the injured primary tooth is disrupted.

With prompt endodontic treatment, a primary tooth can be saved. Pulpotomy and pulpectomy are the most common procedures used to treat pulp injuries:

• Pulpotomy

A pulpotomy procedure, also called a baby root canal, is recommended when the pulp in or near the crown of the tooth has been affected by decay, infection, or trauma while the root pulp remains healthy. After numbing the area, the inflamed or infected pulp inside the crown of the tooth is removed, leaving the root canals intact. The healthy remaining pulp will be covered with a special material to protect and help heal the tooth.

• Pulpectomy

When the pulp inflammation or infection has spread to the root canals as well as the pulp chamber, a traditional root canal procedure is often the best option. After numbing the area around the tooth, all of the pulp tissue will be removed from inside the crown and the roots. The pulp chamber and root canals will then be cleaned, disinfected, shaped, and filled.

• Crowns

A crown is typically placed over the tooth after root canal treatment. When a baby tooth is treated with a pulpotomy or a pulpectomy, the tooth becomes more fragile and prone to fracture. A crown covers the entire visible surface of the tooth, protecting it from further damage. Stainless steel crowns are usually used for children’s teeth, especially for molars, but there are tooth-colored options available.

Even though baby teeth will be replaced by adult teeth, premature loss of a primary tooth can have both short and long-term effects on a child’s health:

• A broken, decayed, or infected tooth can be very painful.
• A healthy set of baby teeth helps a child develop proper chewing and eating habits and encourages pronunciation and speech development.
• Each baby tooth serves as a place holder for the adult tooth which will replace it. If a primary tooth is lost too early, the remaining baby teeth can shift out of place, disrupting the alignment of permanent teeth.
• Missing teeth can affect self-confidence.

There can be good reasons for extracting a seriously damaged baby tooth, and there are situations where root canal treatment is the best and healthiest option for your child’s smile. Whenever tooth pulp has been compromised, visit your child’s dentist immediately for safe, gentle, and effective treatment.